Carolyn Rose Jemison, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

9538329 Issued in FL

Practice address

525 E 15TH St
Panama City, FL 32405-5412

Phone

(850) 522-4485

NPI assigned

Oct 18, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carolyn Rose Ward Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1225791262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 NEW YORK AVE APT A",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443768",
            "telephone_number": "850-867-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 15TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324055412",
            "telephone_number": "850-522-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEMISON",
        "first_name": "CAROLYN",
        "middle_name": "ROSE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9538329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIFE MANAGEMENT CENTER",
            "identifier": "9538329",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "WARD",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Jeffrey Jentink

• Psychiatric/Mental Health Registered Nurse in Panama City, FL
• Providers in Panama City, FL by specialty
• Psychiatric/Mental Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.